Thyroid Problems: Types, Causes, Symptoms & Treatments

The thyroid gland, which is an organ shaped like a butterfly that is located at the base of the neck area, plays a critical role in regulating metabolism processes. When there are issues of thyroid gland that suddenly occur, it causes an array of symptoms that may spread throughout the entire body.

Let’s explore what are the common types of thyroid problems that may occur, exploring their symptoms, causes, and the medications needed to treat these problems.

Types of Thyroid Problems

Essentially, there are two main types of thyroid problems that may occur:

Hyperthyroidism

This type of thyroid problem occurs when the thyroid produces too much thyroid hormone, causing an overactive metabolism process. The prevalence rate of hyperthyroidism worldwide is between 0.2 percent to 1.3 percent of the whole population. As for prevalence in Australia specifically it is estimated that hyperthyroidism affects 3 in 1000 people, according to Hormones Australia.

Hypothyroidism

Conversely, this type of problem occurs when the thyroid doesn’t produce enough thyroid hormone, resulting in an underactive metabolism. It was suggested that the prevalence of hypothyroidism ranges between 1 to 2 percent of the entire population, which is considerably higher than hyperthyroidism.

The same case is also applicable within the context of prevalence in Australia, where the numbers are even higher, affecting an estimated 3 percent According to Hormones Australia, that makes hypothyroidism the most common thyroid problem in Australia.

Causes of Thyroid Problems

The causes of thyroid problems can be diverse, but there are some causes that occur more often within the context of either hyperthyroidism or hypothyroidism.

Common causes of thyroid

Hyperthyroidism

Graves’ Disease
Graves’ disease is an autoimmune disorder that causes hyperthyroidism, where the immune system attacks the thyroid gland, leading to overproduction of thyroid hormones, which can result in symptoms such as weight loss, rapid heartbeat, and anxiety.

Graves’ Disease can be considered as the most common cause of hyperthyroidism, which accounts for approximately between 60 to 80 percent of the cases.

Thyroid Nodules
Thyroid nodules can be described as lumps that can be formed within the thyroid gland, which are typically non-cancerous. These nodules can produce excess thyroid hormones on their own, which at the end causes hyperthyroidism.

In the United States, the prevalence of thyroid nodules occurs at approximately between 4 to 7 percent of the population.

Excessive Iodine Intake
It has been suggested that in some rare cases, an excessive intake of iodine, either through a diet or medications relating to the usage of iodine, may also cause hyperthyroidism. An excessive amount of iodine is also commonly linked with Graves’ disease as the catalysts of hyperthyroiditis.

Hypothyroidism

Hashimoto’s Thyroiditis
Also commonly referred to as Hashimoto’s disease, it’s considered as the most common cause of hypothyroidism. In Hashimoto’s disease, the immune system attacks the thyroid gland, causing inflammation and destruction of thyroid tissue and eventually reducing the productive capabilities of the hormone.

A study suggests that Hashimoto’s disease is the most prevalent cause of hypothyroidism in countries that have an adequate intake of iodine, specifically the United States. It has been estimated that women are more susceptible to Hashimoto’s disease compared to their male counterparts, with women being almost four times more likely than men to be diagnosed.

Thyroid Removal Surgery
It has been found that in some cases, a surgical procedure such as a lobectomy to remove all or some parts of the thyroid gland for treating thyroid cancer or large nodules may result in hypothyroidism, commonly known as postoperative hypothyroidism.

However, it is important to consider that in this specific case, this condition is usually transient and the symptoms may subside after a period of time. This has been proven when almost 70 percent of the study’s subjects spontaneously recovered to euthyroidism, which is a condition where the thyroid functions back to normal, within 24 months after the surgery, without any thyroid-hormone replacement treatment procedures.

Radiation Therapy to the Neck

Radiotherapy procedure within the head and neck areas as a treatment for cancer may have caused hypothyroidism. This is because the thyroid gland is particularly vulnerable towards radiation, and doing radiotherapy can cause damage towards the thyroid glands.

Doing the procedure may result in a decreased amount of thyroid hormone production, which can be the catalyst for hypothyroidism. Studies also suggested that radiotherapy-induced hypothyroidism is particularly common, requiring treatments and follow-up checks periodically. 

Iodine Deficiency
A severe level of iodine deficiency may have caused multiple thyroid disorders, such as goitre and hypothyroidism. Despite resulting in an increase in thyroid activities to try to subside the iodine intakes back to its normal requirement, this specific condition occurred because eventually, the iodine concentrations are still too low to enable production of thyroid hormones, which leads to thyroid disorders, including hypothyroidism.

Developing countries, where they do not have enough access to iodized salts, are thought to be more susceptible towards iodine deficiency in comparison to developed countries. 

The research also mentioned that infants are specifically the group that is most at risk of hypothyroidism because of iodine deficiency, which may impair their potential neuromotorical functions.

Symptoms of Thyroid Problems

The symptoms of thyroid problems can vary depending on the type and severity of the condition. Here’s a general overview of the symptoms for both hyperthyroidism and hypothyroidism:

Hyperthyroidism

  • Weight loss: Hyperthyroidism increases metabolism, which burns calories faster which results in weight loss even if there’s an increased food intake.
  • Anxiety: Excess thyroid hormones caused by hyperthyroidism over-stimulates the nervous system, which causes anxiety and feeling of nervousness.
  • Irritability: Excess thyroid hormones also alter mood and behaviour, resulting in irritability.
  • Rapid heart rate: Thyroid hormones increase the heart rate, and an excess amount of the hormones can lead to palpitations.
  • Hand tremors: Increasing thyroid hormones can affect tremors within the hands because of overstimulation of the nervous system.
  • Heat intolerance: Hyperthyroidism can raise the body’s metabolism, increasing heat production and causing intolerance to heat for the body.
  • Bulging eyes: This symptom is commonly associated with Graves’ disease, in which inflammation and tissue buildup behind the eyes cause them to protrude and look bulging.
  • Difficulty sleeping: Increasing nervous system activities caused by hyperthyroidism can lead to difficulty sleeping.
  • Diarrhoea: Increasing digestive activities can lead to more frequent bowel movements, which can lead to diarrhoea.

Hypothyroidism

  • Weight gain: A slower metabolism due to reduced amount of thyroid hormones can cause weight gain, even if there’s a decreased food intake.
  • Fatigue: Reduced thyroid hormones also slow down bodily processes, leading to a feeling of fatigue and lethargy.
  • Cold intolerance: Hypothyroidism decreases the body’s ability to generate heat, resulting in the body to feel intolerant to the cold.
  • Dry skin: A reduced thyroid hormone can also decrease sweating, which leads to dry and coarse skin.
  • Hair loss: Thyroid hormones are important for the process of hair growth, and their deficiency can lead to hair loss.
  • Constipation: A slowed metabolism can cause a decrease in digestive tract process, often resulting in constipation.
  • Muscle weakness: Hypothyroidism can cause muscle cramps and weakness due to decreased energy production and altered muscle metabolism.
  • Depression: Reduced thyroid hormone levels can affect mood and brain function, leading to depression and cognitive difficulties.
  • Irregular periods: Hypothyroidism can affect the hormones in the reproductive system, which can lead to menstrual irregularities, including heavy or irregular periods.

Medications for Thyroid Problems

There are various medications that can help manage thyroid problems, both hyperthyroidism and hypothyroidism:

Hyperthyroidism

Antithyroid Medications

Antithyroid medications such as methimazole (MMI) and propylthiouracil (PTU) are considered as the most preferable drug options to reduce the production of thyroid hormones, making them commonly used for managing the symptoms of hyperthyroidism, specifically in Graves’ disease. 

Despite similar effects in terms of its efficacy, methimazole is generally preferred due to fewer side effects compared to propylthiouracil. Methimazole does have a reduced risk of birth defects among pregnant women with hyperthyroidism, compared to propylthiouracil. Another study also suggested similar results within the context of propylthiouracil increases risk of liver injury compared to methimazole.

Radioactive Iodine (I-131) Therapy

This treatment involves ingesting a certain amount of radioactive iodine, which selectively destroys overactive thyroid cells, thereby reducing hormone production.

Results have shown that I-131 therapy, particularly high amounts of dosage, is effective and considered as a common, first-line treatment for hyperthyroidism, although periodical follow-up checks should be considered.

Surgery (Thyroidectomy)

If multiple medications are not efficient enough for the patients, a surgical approach of thyroidectomy, which is a procedure of removing of the thyroid gland, either partial or total, can be an option.

However, despite this specific treatment being less common due to the risks associated with surgery, including hypothyroidism, it has been considered as a definitive treatment of hyperthyroidism compared to I-131 therapy.

Hypothyroidism

Levothyroxine (LT4)

The primary treatment for hypothyroidism is levothyroxine (LT4). This medication is typically taken daily to maintain normal hormone levels and alleviate symptoms of hypothyroidism. LT4 medications, especially during the evening and bedtime, significantly improved thyroid hormone levels, subsiding symptoms of hypothyroidism.

Levothyroxine & Liothyronine

In some cases, a combined usage of levothyroxine (LT4) and liothyronine (LT3) may be prescribed for patients who do not respond adequately to levothyroxine alone.

Results have suggested that patients treated for autoimmune hypothyroidism preferred a combination of both LT3 and LT4 treatments over the treatment of LT4 alone, although the results inclined that it was not efficient enough to be considered as the main treatment of hypothyroidism.

Cannabinoids as an Option for Treatment

The recent studies that understand usage of cannabinoids, specifically CBD, as a treatment for thyroid problems, although existent, remain scarce at the moment, thus making the efficacy of its usage relatively inconclusive.

However, it has been suggested by some studies that the usage of CBD can be an option for treating hypothyroidism, suggesting that CBD usage was significantly associated with lower levels of TSH, indicating that it minimised the symptoms of hypothyroidism, despite little association between CBD usage with thyroid dysfunctions treatment. The evidence base remains small and developing. 

An extensive consultation with medical experts is essentially very important if considering usage of cannabinoids, as the side effects of its usage may exceed the potential efficacy in dealing with hypothyroidism.

Living with Thyroid Problems

The thyroid gland, though small in terms of its size, plays a considerably vital role in regulating metabolism and overall body health. When this regulation process goes wrong in the slightest, it can result in thyroid problems, either with hyperthyroidism or hypothyroidism, each with distinct symptoms and causes. Fortunately, with proper diagnosis and treatment, most thyroid problems can be effectively managed.

Early detection is key, so if there are any noticeable signs or symptoms suggestive of a thyroid problem such as unexpected weight changes, fatigue, or even heart palpitations, consult your a medical expert immediately.  Through multiple diagnoses such as blood tests and potentially imaging studies, they can determine the root causes and recommend the appropriate treatment plan, accordingly. With proper management, you can achieve optimal thyroid function and live a healthy, fulfilling life.

Written by

Priyom holds a Ph.D. in Plant Biology and Biotechnology from the University of Madras, India. She is an active researcher and an experienced science writer. Priyom has also co-authored several original research articles that have been published in reputed peer-reviewed journals. She is also an avid reader and an amateur photographer.

Written by

Priyom holds a Ph.D. in Plant Biology and Biotechnology from the University of Madras, India. She is an active researcher and an experienced science writer. Priyom has also co-authored several original research articles that have been published in reputed peer-reviewed journals. She is also an avid reader and an amateur photographer.

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